Tier 1
Application for Refund of Additional Member Contributions For Transit 25-Year/Age 55 Members
Form #336
This application is for: (1) current and former members of the Tier 4 Transit 25-Year/Age 55 retirement plan (T25/55) and (2) former participants of a Chapter 96 Plan (55/25 or 57/5) who are or were employed in the title of Supervisor (Stations) in Assignment Level II in the NYC Transit Authority Stations Department, who wish to receive a refund of accumulated Additional Member Contributions (AMCs).
Application for Refund of Additional Member Contributions
Form #333
Members who are no longer eligible to participate in a special retirement plan may be eligible to receive a refund of their additional member contributions. Note that by withdrawing your additional member contributions, your membership and all associated rights, benefits, and privileges will end.
Tier 1 Age and Service Requirements for Retirement Eligibility
This Fact Sheet provides Age and Service requirements for various Tier 1 retirement plans at a glance.
Affidavit for Retroactive Election to Reduce Annuity Contributions by the Amount Required for Social Security Coverage – Tier 1
Form #218
Submit this form if you did not pay pension contributions and had not filed the proper form to request that option.
Election to Change the Present Method of Payment of Social Security Coverage – Tier 1 and Tier 2
Form #217
Social Security offset allows you to reduce some or all of your Basic Contribution Rate by the percentage taken out of your paycheck for Social Security. By electing this option, you may end up with a deficit in your account. Please read this form carefully, as your action will affect the annuity component of your future retirement benefit.
Request for Election or Change of Voluntary Contributions As Provided by the Transit 20-Year Non-Contributory Plan – Tier 1
Form #216
As a Tier 1 member of the Transit 20-year Non-Contributory Plan, you may elect to contribute voluntarily at the rates listed in this form. You will enhance your future retirement benefit by contributing toward its annuity component.
Revocation of Election to Pay Extra Salary Deductions to Provide for Additional Annuity at Retirement – Tier 1 and Tier 2
Form #215
File this form if you elected to contribute 50 percent more than your normal rate of contribution and now wish to cancel this election.
Election to Pay Extra Salary Deductions to Provide for Additional Annuity at Retirement – Tier 1 and Tier 2
Form #214
By filing this form, you will start paying 50 percent more than your normal rate of contribution, which will increase your annuity at retirement and enhance your retirement benefit.
Application to Restore Rate of Deduction – Tier 1 and Tier 2
Form #211
For Tier 1 and Tier 2 members who cancelled their Rate of Deduction and discontinued making pension contributions and now wish to start contributing again.
Election to Contribute Additional Contributions – Tier 1 and Tier 2
Form #210
For Tier 1 members in the 55-Year Increase-Service-Fraction Plan (Plan B) and Tier 2 members in the Modified-55 Increased-Service-Fraction Plan (Plan D) who wish to increase their pension contributions.
Application for Disability Retirement – Tier 1
Form #601
Use this application if you are a Tier 1 member and wish to collect a retirement benefit due to disability.
Request for Information
Form #852
If the information you are looking for is not available online or over the phone, please use this form to submit your request in writing.
Application to Change Federal Income Tax Withheld
Form #349
Use this form to change how much Federal income tax is withheld from your monthly pension check. If you need assistance in determining which tax withholding selections to make, please consult with a professional tax preparer or visit the Internal Revenue Service (IRS) website at www.irs.gov/forms-pubs/about-form-w-4-p.
Processing Death Benefits
Fact Sheet #702
An overview of NYCERS’ policies and procedures for processing a death benefit claim.
Disability Retirement – Tier 1 and Tier 2
Brochure #921
The disability retirement process for Tier 1 and 2 members.
Disability Retiree Requirement to Report Personal Service Income Each Year
Form #618
By filing this form, you consent to report your annual income to NYCERS while a disability retiree.
Waiver Pursuant to the Provisions of Article 14 of the Retirement and Social Security Law (RSSL) as it Pertains to Disability Retirements
Form #614
File this form with NYCERS if you want to waive the benefits of any statutory presumption relating to the cause of disability or eligibility for disability benefits
Final Medical Review Waiver (To be completed by the Member)
From #613
This form is for applicants for disability retirement benefit who want to waive the process by which a member can contest the findings of NYCERS’ Medical Board denying his or her disability claim
Agency Report on Accident
Form #607
This form must be completed by your employer.
Physician’s Report of Disability
Form #606
This form contains your physician’s medical report and your authorization to provide information to NYCERS’ Medical Board.